Goal: To reduce the morbidity and mortality of cancer by improving the care of the cancer patient through better organization of the cancer health delivery system so that all modalities and all aspects of cancer control are available to every cancer patient regardless of her/his point of entry into the system. Approach: To achieve this goal, two model Cancer Management Systems have been established. A System is defined as a small group of hospitals that have formally agreed to pool their cancer care resources to improve the care of patients primarily utilizing these local resources. The first System has been established in Springfield, Massachusetts, between three urban, general hospitals. A Policy Board and Committees composed of Springfield health professionals, have autonomous responsiblity for the Springfield Cancer Management System. The second System, recently finalized, will be in Bangor, Maine, and will provide a model of a rural cancer care system. Activities: The Springfield System has been in operation for eight months and has undertaken the following activities: development of guidelines for minimum cancer screening of all hospital admissions; nursing standards of care with respect to pain; a weekly calendar of oncology events for physicians within the area; a review course for physicians; and planning towards a Central Tumor Registry.